Purpose for the program: Discussions between the staff nurses in the Neonatal Intensive Care Unit (NICU) and the Parent Education and Lactation Services resulted in an interest in improving breastfeeding outcomes in a level 3 neonatal intensive care unit after attending a professional conference. According to literature, exclusive breastfeeding for the first 6 months of life, continuing for one year or more is recommended by the Academy of Pediatrics.  The 10 steps to successful breastfeeding, leading to Baby Friendly Hospital Designation, support the healthy full term infant. Although the ill or premature infant may benefit most from mother’s own milk, obstacles leading to successful breastfeeding can occur with the separated mother/infant pair during hospitalization. Mentoring provides a safe environment in which new skills can be developed and transferred into actual practice

Proposed change: This collaborative effort between managers, physicians, NICU staff nurses, nurse lactation consultants and nurse research facilitator / neonatal nurse practitioner seeks to enhance communication between members of both departments, as well as help explore clinical pathways to benefit vulnerable infants to receive their mother’s milk.

Implementation, outcomes and evaluation: A written plan was submitted and approved by managers from both units. Three key members selected from each department meet monthly. First project identified: Improving the NICU staff nurses’ knowledge and skills necessary for initiation of lactation and mother’s pumping breast milk.  Key members from Parent Education and Lactation Services taught pumping breast milk skills to key members from NICU.  A pretest of 5 basic questions on pumping breast milk was developed and administered to NICU staff.  A computer based program consisting of an educational Power Point presentation was developed by the team and sent to NICU staff for 1 month. Pretest revealed 17.2% response rate from NICU staff of 5 basic questions.  2 questions 50% correct. 3 questions 80% correct.  Goal is 90% correct for all 5 basic questions.  Post test 8.6% response.  3 questions 90% correct.  2 questions 60% correct.  Support for education by managers on infant nutrition and breastfeeding should be developed for NICU staff, especially for nurses considering a clinical ladder. Reflecting on low test response, qualitatively explore NICU nurses’ attitudes on breastfeeding. Prospectively, factors associated with breastfeeding outcomes may be investigated.

Implications for nursing practice: This pilot project can be expanded to other maternal/child units in the hospital system.

Keywords: Pumping breast milk, mentoring, premature infant